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General NPI Number Information
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NPI Number | 1114538626
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Entity Type | Individual
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Provider Name | AMY POTTER FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/10/2020
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 1800 E 3RD AVE STE 108
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City | DURANGO
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State | CO
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Zip | 81301-5046
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Country | US
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Telephone | 970-403-6675
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4330
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City | AVON
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State | CO
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Zip | 81620-4330
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Country | US
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Telephone | 970-926-6340
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Fax | 970-926-6348
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 64192
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1616862
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN00995863-NP
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License Number State | CO
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